老年与非老年肥胖症患者行减重手术临床疗效的Meta分析  

Clinical efficacy of bariatric surgery for elderly and nonelderly obese patients： a Meta analysis

作　　者：李伟婧[1] 宋京海[1] 曾平[2] 奚桓[3] 

机构地区：[1]北京医院国家老年医学中心普通外科,100730 [2]北京医院老年医学研究所,100730 [3]北京医院老年医学部,100730

出　　处：《中华消化外科杂志》2017年第6期596-601,共6页Chinese Journal of Digestive Surgery

基　　金：中央保健科研基金（W2013BJ05）

摘　　要：目的系统评价老年（年龄≥60岁）或非老年（年龄〈60岁）肥胖症患者行减重手术的临床疗效。方法以bariatricsurgery、metabolicsurgery、gastricbypass、gastricband、sleevegastrectomy、biliopancre—aticdiversion、elderly、aged、over60years为检索词，检索PubMed、Embase、TheCochraneLibrary。检索时间为2006年1月至2016年6月。纳入比较老年与非老年肥胖症患者行减重手术临床疗效的队列研究，手术方式不限。患者年龄≥60岁设为老年组，〈60岁设为非老年组。由两名研究者独立筛选文献和提取数据，并进行质量评价。计数资料采用比值比（OR）及95％可信区间（95％cf）表示。采用，2对异质性进行分析。结果最终纳入符合标准的相关研究共11篇，均为回顾性研究，累计样本量9913例，其中老年组792例，非老年组9121例。Meta分析结果显示：老年组和非老年组肥胖症患者行减重手术后早期病死率、术后早期并发症发生率、术后糖尿病缓解率、术后高血压病缓解率、术后高脂血症缓解率、术后睡眠呼吸暂停综合征缓解率比较，差异均无统计学意义（OR=3．31，1．94，1．00，0．61，0．99，1．40，95％C／：0．86～12．77，1．01～3．74．0．66～1．50，0．34～1．10，0．42～2．29，0．72．2．72，P〉O．05）。结论老年肥胖症患者行减重手术安全性和临床疗效与非老年患者相当。Objective To systematically evaluate the clinical efficacy of bariatric surgery for elderly （ age /〉60 years） or nonelderly { age 〈60 years） obese patients. Methods Literatures were researched using PubMed, Embase, Cochrane Libral？J from January 2006 to June 2016 with the key words including ＂bariatric surgery, metabolic surgery, gastric bypass, gastric band, sleeve gastrectomy, biliopancreatic diversion, elderly, aged, over 60 years＂. The cohort study about clinical efficacy of bariatric surgery for elderly or nonelderly obese patients were received and enrolled, and surgical procedures were unrestricted. Patients with age I〉60 years and with age 〈60 years were respectively allocated into the elderly group and nonelderly group. Two reviewers independently screened literatures, extracted data and assessed the risk of bias. Count data were described as odds ratio （OR） and 95% confidence interval （CI）. The heterogeneity of the studies was analyzed using the 12 test. Results Eleven retrospective studies were enrolled in the Meta analysis, and the total sample size was 9 913 patients, including 792 in the elderly group and 9121 in the nonelderly group. The results of Meta analysis showed that there were no statistically significant differences in the early mortality, incidence of postoperative early complication, remission rates of postoperative diabetes, postoperative hypertension, dyslipidemia and obstructive sleep apnea syndrome between elderly group and nonelderly group （OR=3.31, 1.94, 1.00, 0.61, 0.99, 1.40, 95%CI： 0.86-12.77, 1.01-3.74, 0.66-1.50, 0,34-1.10, 0.42-2.29, 0.72-2.72,P〉0.05）. Conclusion The safety and clinical efficacy of bariatric surgery in the elderly obese patients are equivalent to that of nonelderly patients.

关 键 词：肥胖症 减重手术 安全性 有效性 META分析 

分 类 号：R656.6[医药卫生—外科学]